Evidence-based practices (EBPs) are not widely used by drug treatment providers. The goal of this Research Center application for the TRIALS Cooperative Agreement funding mechanism is to promote the adoption and routine practice of two drug treatment EBPs in outpatient settings for juvenile offenders in drug court programs in Mississippi. Drug treatment providers already educate clients about HIV and make referrals for HIV testing. We will also promote the integration of an evidence-based HIV prevention intervention with adolescent drug treatment services. To attain this goal, two state-level agencies, juvenile justice and mental health, collaborated in the development of the proposed research concept. Drawing on implementation frameworks that view organizational change as taking place in stages, requiring intentional and sustained effort to occur, we take a stage-based approach in which different implementation strategies are employed at each stage of the implementation process. Based on our HIV prevention experience with juvenile offenders, our knowledge of the public sector treatment system in Mississippi, and the types of drug treatment interventions desired by youth court judges, we selected the 12 session version of Motivational Enhancement Therapy combined with Cognitive Behavioral Therapy (MET/CBT12), the Family Support Network (FSN) intervention and Becoming a Responsible Teen (BART) HIV/STD prevention program as the EBPs to be implemented. To maximize the likelihood that juvenile drug court programs and treatment providers will participate throughout the 5-year study and will not only implement, but sustain the use of these EBPs after grant funding is withdrawn, we propose to develop a collaborative partnership with each juvenile drug court program and to facilitate local implementation planning groups (stage 1), provide training, coaching and performance feedback to treatment providers (stages 2 & 3), and provide site-specific information to drug court program stakeholders on service delivery, youth outcomes, costs and cost effectiveness (stage 4). We plan to use mixed methods for examining contextual, organizational, and other factors hypothesized to influence implementation and to use various statistical approaches to test a different hypothesized model for each stage of the implementation process. By tracking the progress of drug court programs across all stages of the implementation process and delineating the implementation facilitators and barriers, our research concept will contribute to implementation science. The proposed project has the potential to make a significant impact on the diffusion of EBPs in Mississippi as youth court judges will want to adopt adolescent drug treatment and HIV prevention interventions tried and found effective by their peers. Furthermore, results of implementation research conducted in Mississippi have implications for EBP implementation in other resource-poor settings.
Evidence-based practices (EBPs) for outpatient adolescent drug treatment are available, but are not widely used due to various implementation challenges. In addition, drug treatment providers educate clients about HIV and make referrals for HIV testing, but evidence-based HIV prevention intervention is not integrated with drug treatment services. Several strategies for implementing evidence-based drug treatment and HIV prevention in juvenile drug court programs in Mississippi will be tested, the results of which will have implications for EBP implementation in other resource poor settings.
